| Because of concerted public promotion and education, coupled with ease of access, the telephone number, 911, has become both the public's emergency services access point and the source for non-emergency information and assistance. A large segment of the population that is looking to 911 and Emergency Medical Services (911-EMS) agencies for medical assistance actually require something less intensive than a 'lights-and-sirens' emergency response. However, most 911-EMS agencies do not have service options other than that, and an emergency 'lights-and-sirens' ambulance response is what usually occurs for most calls to 911.; In reality, many callers for 911-EMS could benefit from service options such as telephone nurse advice, non-emergency transportation, or referral to other available services (physician offices, social services, etc.)---options that are not typically provided by 911-EMS agencies.; This dissertation examines "Routing," defined for purposes of this dissertation as the various strategies now being used by a limited number of 911-EMS agencies to provide a continuum of necessary services in addition to 'lights and-sirens' response. The objective of Routing is to ensure that a person that has an unscheduled medical need is 'routed' to the most appropriate sources of care. This can range from a 911-EMS response to a nurse-advisor facilitating arrangements for a clinic appointment. This is not to say that patients with non-urgent conditions do not need medical care; rather, they do not need emergency medical care.; As this is the first such study of 911-EMS Routing, the research conducted for this dissertation required a qualitative research design using an exploratory and descriptive case study approach to examine the findings.; The dissertation demonstrates that: (1) Routing has reduced the numbers of non-urgent calls responded to by a number of 911-EMS agencies; thereby freeing the 911-EMS agencies from responding to non-emergency calls and instead increasing their ability to remain on stand-by for emergencies, (2) Most Patients/Callers were satisfied with being Routed, (3) Agencies that Route can have lower operations expenses than those that do not Route, and (4) No callers died or had their conditions aggravated by being routed. |
